What is cashless mediclaim insurance?

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What is cashless mediclaim insurance?

Max Bupa

23 September 2020

With the onset of COVID-19, Mediclaim insurance has become exponentially more important. Many people now give the policy real consideration, as they reassess the long-term payoff of the investment and monthly premium payments that have no plausible short-term returns. One of the worries regarding insurance that many have had is the hassle of claims settlement and having to negotiate the fine print and paperwork during a stressful time. This is where Cashless Mediclaim Insurance has come in and made things simpler. 


The rise of Cashless Mediclaim Policies -


Traditionally, there are two modes of availing of an individual’s health insurance cover: A reimbursement policy, and cashless Mediclaim insurance. As the name suggests, the reimbursement method requires the insured to cover charges upfront, and then apply for reimbursement from the health insurance company later. It is evident why these consumers were extremely discontent with this policy. For instance, one would expect, upon the purchase of a Mediclaim insurance, that they would not be required to save up for medical expenses as their insurance company is meant to cover it. Having to pay upfront beats this purpose. Additionally, most medical treatment facilities are unlikely to begin treatment without receiving at least part payment. In the event that the insured does not have the money on hand despite paying their premiums regularly, their health insurance is practically of no use. Medical care is a time sensitive process, and any delays could have potentially fatal effects.

Thus, came about the concept of cashless Mediclaim insurance to offer a more frictionless experience to policyholders.


What is Cashless Mediclaim Insurance? 


As suggested by its name, cashless Mediclaim insurance is the process of availing of your cover without any cash transactions taking place. This means that at the point of admission to a medical facility, the insured will not have to pay any amount upfront and can have their medical procedures and treatment commence at the earliest. In order to avail of their insurance cover, all an individual has to do is to intimate their insurance provider about the expenditure that is going to be made on medical treatment.

Once this is done, and once it has been approved (assuming the illness treatment and additional costs are covered by the company), the insurance company will transfer the payment directly and account for all hospital expenses, without the patient (the insured) having to take any additional steps or making any additional payments that may hinder their treatment.


Why buy Cashless Mediclaim Insurance?


The biggest benefit of buying cashless Mediclaim insurance is that as long as an individual regularly makes their premium payments on time, they need not worry about keeping funds aside for medical expenses as the insurance company will cover these expenses without any other procedure required.

Additionally, due to the speed of transactions and lack of physical exchange of funds, the payment process is expedited and can be completed much early, allowing for efficient medical treatment at the earliest.


Making sure your local or preferred hospital supports Cashless Mediclaim Insurance - 


Similar to other medical insurance policies, cashless Mediclaim insurance is available for all types of policies, be it an individual plan, a family floater health insurance, senior citizen health insurance or even group health insurance.

However, before choosing any cashless Mediclaim policy, it is imperative that you look into whether your local hospital or any hospitals you are likely to frequent or be taken to in the case of  medical emergency provides a cashless Mediclaim insurance feature with your insurance company of choice.

This is essential as cashless Mediclaim insurance is only provided in a network of hospitals that the insurance company has previously reached out to and made their cashless insurance available at that hospital. If one overlooks this, they might end up, at the time of need, realising that their hospital does not support cashless Mediclaim insurance for the company they purchased it from and will not be able to avail of any amount of their cover. In this situation, they will have to refer to the reimbursement method, which will only be an option for those who have the money to spare or have the money available at all.

Therefore, one must always ensure that their hospital provides a cashless Mediclaim insurance facility with their company of choice and in the list of network hospitals that your health insurer provides cashless facility in.




Cashless Mediclaim insurance is the pinnacle of technologically fueled insurance services. With near instant clearance combined with a much lower rejection rate, it is a much needed development in the medical insurance space. According to a 2016 NSSO report, about 80% of Indians are not covered under a health insurance plan, with only 18% of the urban and 14% of the rural population being covered by health insurance.

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